Simulation for non-pedagogical purposes has begun to emerge. Examples include quality improvement... more Simulation for non-pedagogical purposes has begun to emerge. Examples include quality improvement initiatives, testing and evaluating of new interventions, the co-designing of new models of care, the exploration of human and organizational behaviour, comparing of different sectors and the identification of latent safety threats. However, the literature related to these types of simulation is scattered across different disciplines and has many different associated terms, thus making it difficult to advance the field in both recognition and understanding. This paper, therefore, aims to enhance and formalize this growing field by generating a clear set of terms and definitions through a concept taxonomy of the literature. Due to the lack of alignment in terminology, a combination of pearl growing, snowballing and citation searching approach was taken. The search was conducted between November 2020 and March 2023. Data were extracted and coded from the included papers according to seven...
Background: In 2009, an audit into the death of a patient with a diagnosis of acute kidney injury... more Background: In 2009, an audit into the death of a patient with a diagnosis of acute kidney injury (AKI) revealed several shortcomings in the management of AKI patients in UK hospitals. The National Confidential Enquiry into Patients Outcome and Death (NCEPOD) reports that the poor management of AKI is commonly related to poor clinical care, and it is recommended that all clinical staff receive regular teaching on AKI to improve their knowledge and skills. Aim: This study aimed to establish the level of understanding of healthcare professionals caring for patients with AKI and ways to provide intervention to overcome any deficiencies. Method: This study used a cross-sectional online questionnaire survey. The questionnaire was posted using the Survey Monkey online tool and sent via a link to healthcare professionals. The links allowed respondents to answer the questions and recorded their anonymised responses. The online survey link was sent out via mail to the staff of three Trusts w...
Background: Cardiac arrest (CA) is associated with morbidity and mortality due to cerebral ischem... more Background: Cardiac arrest (CA) is associated with morbidity and mortality due to cerebral ischemia. We therefore tested the hypothesis that higher regional cerebral oxygenation (rSO2) during resuscitation is associated with improved return of spontaneous circulation (ROSC), survival and neurological outcomes at hospital discharge. We further examined the validity of rSO2 as a test to predict these outcomes. Methods: Multicenter prospective study of in-hospital CA (IHCA). Inclusion criteria: IHCA, age≥18 years, Prolonged CPR≥5 minutes. Patients were recruited consecutively during working hours between 08/2011-09/2014. Survival with a favorable neurological outcome was defined as a Cerebral Performance Category (CPC)1-2. Results: Among 504 IHCA events, 183 (36%) met inclusion criteria. Overall 62/183 (33.9%) achieved ROSC, while 13/183(7.1%) achieved CPC1-2 at discharge. Higher mean±SD rSO2 was associated with ROSC vs. no ROSC (51.8±11.2% vs. 40.9±12.3%) and CPC1-2 vs. CPC3-5 (56.1±1...
Background: Real time recognition of the quality of brain oxygen delivery is critical during resu... more Background: Real time recognition of the quality of brain oxygen delivery is critical during resuscitation. Although end tidal CO2 monitoring (ETCO2) has been proposed as a marker of organ perfusio...
BMJ Simulation and Technology Enhanced Learning, 2020
Introduction Teamwork plays an essential role in providing quality health care while ensuring goo... more Introduction Teamwork plays an essential role in providing quality health care while ensuring good outcomes and safe practices in any healthcare system. This has been demonstrated in several studies in emergency care where resuscitation teams perform at high level to achieve desired outcomes in life threatening situations.1 Simulation has been identified as an effective way of improving team performance skills especially in the acute care settings where team dynamics change rapidly and requires good collaboration.2 In addition to clinical competence, the members of the team also need to be conversant with non-technical skills such as team leadership and communication Methods The MEDLINE, EMBASSE and Cochrane library databases were searched for original articles from the last 20 years, investigating team performance in a multidisciplinary team-based simulation training in acute care settings. The research questions were developed using the participants, intervention, comparisons, out...
This article has been double-blind peer reviewedIn this article…Current national guidance on card... more This article has been double-blind peer reviewedIn this article…Current national guidance on cardiopulmonary resuscitation (CPR)A fitness to practise hearing by the Nursing and Midwifery Council relating to CPRImportance of advance care and emergency care planningAbstractIn January 2017, the Nursing
Objective To develop an assessment instrument that can be used as a comprehensive feedback record... more Objective To develop an assessment instrument that can be used as a comprehensive feedback record to convey to a trainer the non-technical aspects of skill acquisition and training. Methods The instrument was developed across three rounds. In Round 1, 6 endourological consultants undertook a modified Delphi process. Round 2 included 10 trainers who assessed each question’s relevance and practicability. Round 3 involved a pilot study with fifteen urology residents who participated in a technical skills simulation session with the incorporation of the instrument. We report the content, face, and construct validity, and the internal consistency of an NTS instrument for trainers. Results The instrument had a consistent and a high positive average for each of the 4 sections of the instrument, regardless of the type of user. Positive Spearman’s correlation coefficients (0.02 to .64) for content validity and Cronbach’s alpha (a = 0.70) indicated good validity and moderate reliability of th...
The automatic triggering of a critical incident review for all unexpected cardiac arrests, as pro... more The automatic triggering of a critical incident review for all unexpected cardiac arrests, as proposed by the National Patient Safety Agency (news August 25), should enable organisations to identify readily the remedial factors that may contribute towards a 'failure to rescue'.
Simulation for non-pedagogical purposes has begun to emerge. Examples include quality improvement... more Simulation for non-pedagogical purposes has begun to emerge. Examples include quality improvement initiatives, testing and evaluating of new interventions, the co-designing of new models of care, the exploration of human and organizational behaviour, comparing of different sectors and the identification of latent safety threats. However, the literature related to these types of simulation is scattered across different disciplines and has many different associated terms, thus making it difficult to advance the field in both recognition and understanding. This paper, therefore, aims to enhance and formalize this growing field by generating a clear set of terms and definitions through a concept taxonomy of the literature. Due to the lack of alignment in terminology, a combination of pearl growing, snowballing and citation searching approach was taken. The search was conducted between November 2020 and March 2023. Data were extracted and coded from the included papers according to seven...
Background: In 2009, an audit into the death of a patient with a diagnosis of acute kidney injury... more Background: In 2009, an audit into the death of a patient with a diagnosis of acute kidney injury (AKI) revealed several shortcomings in the management of AKI patients in UK hospitals. The National Confidential Enquiry into Patients Outcome and Death (NCEPOD) reports that the poor management of AKI is commonly related to poor clinical care, and it is recommended that all clinical staff receive regular teaching on AKI to improve their knowledge and skills. Aim: This study aimed to establish the level of understanding of healthcare professionals caring for patients with AKI and ways to provide intervention to overcome any deficiencies. Method: This study used a cross-sectional online questionnaire survey. The questionnaire was posted using the Survey Monkey online tool and sent via a link to healthcare professionals. The links allowed respondents to answer the questions and recorded their anonymised responses. The online survey link was sent out via mail to the staff of three Trusts w...
Background: Cardiac arrest (CA) is associated with morbidity and mortality due to cerebral ischem... more Background: Cardiac arrest (CA) is associated with morbidity and mortality due to cerebral ischemia. We therefore tested the hypothesis that higher regional cerebral oxygenation (rSO2) during resuscitation is associated with improved return of spontaneous circulation (ROSC), survival and neurological outcomes at hospital discharge. We further examined the validity of rSO2 as a test to predict these outcomes. Methods: Multicenter prospective study of in-hospital CA (IHCA). Inclusion criteria: IHCA, age≥18 years, Prolonged CPR≥5 minutes. Patients were recruited consecutively during working hours between 08/2011-09/2014. Survival with a favorable neurological outcome was defined as a Cerebral Performance Category (CPC)1-2. Results: Among 504 IHCA events, 183 (36%) met inclusion criteria. Overall 62/183 (33.9%) achieved ROSC, while 13/183(7.1%) achieved CPC1-2 at discharge. Higher mean±SD rSO2 was associated with ROSC vs. no ROSC (51.8±11.2% vs. 40.9±12.3%) and CPC1-2 vs. CPC3-5 (56.1±1...
Background: Real time recognition of the quality of brain oxygen delivery is critical during resu... more Background: Real time recognition of the quality of brain oxygen delivery is critical during resuscitation. Although end tidal CO2 monitoring (ETCO2) has been proposed as a marker of organ perfusio...
BMJ Simulation and Technology Enhanced Learning, 2020
Introduction Teamwork plays an essential role in providing quality health care while ensuring goo... more Introduction Teamwork plays an essential role in providing quality health care while ensuring good outcomes and safe practices in any healthcare system. This has been demonstrated in several studies in emergency care where resuscitation teams perform at high level to achieve desired outcomes in life threatening situations.1 Simulation has been identified as an effective way of improving team performance skills especially in the acute care settings where team dynamics change rapidly and requires good collaboration.2 In addition to clinical competence, the members of the team also need to be conversant with non-technical skills such as team leadership and communication Methods The MEDLINE, EMBASSE and Cochrane library databases were searched for original articles from the last 20 years, investigating team performance in a multidisciplinary team-based simulation training in acute care settings. The research questions were developed using the participants, intervention, comparisons, out...
This article has been double-blind peer reviewedIn this article…Current national guidance on card... more This article has been double-blind peer reviewedIn this article…Current national guidance on cardiopulmonary resuscitation (CPR)A fitness to practise hearing by the Nursing and Midwifery Council relating to CPRImportance of advance care and emergency care planningAbstractIn January 2017, the Nursing
Objective To develop an assessment instrument that can be used as a comprehensive feedback record... more Objective To develop an assessment instrument that can be used as a comprehensive feedback record to convey to a trainer the non-technical aspects of skill acquisition and training. Methods The instrument was developed across three rounds. In Round 1, 6 endourological consultants undertook a modified Delphi process. Round 2 included 10 trainers who assessed each question’s relevance and practicability. Round 3 involved a pilot study with fifteen urology residents who participated in a technical skills simulation session with the incorporation of the instrument. We report the content, face, and construct validity, and the internal consistency of an NTS instrument for trainers. Results The instrument had a consistent and a high positive average for each of the 4 sections of the instrument, regardless of the type of user. Positive Spearman’s correlation coefficients (0.02 to .64) for content validity and Cronbach’s alpha (a = 0.70) indicated good validity and moderate reliability of th...
The automatic triggering of a critical incident review for all unexpected cardiac arrests, as pro... more The automatic triggering of a critical incident review for all unexpected cardiac arrests, as proposed by the National Patient Safety Agency (news August 25), should enable organisations to identify readily the remedial factors that may contribute towards a 'failure to rescue'.
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